Got Implants That Were Too Large for My Body, I Want Perky, Small Boobs, Advice? (photo)

5'4" 98lbs, petite! Surgeon deflated 480cc implants last week, that he put in initially 2 months ago; they were HUGE for my body. I'm scheduled to have surgery tomorrow, replacing my implant for 255cc saline low-profiles. I'm 24. I want perky small boobs that match my body size. I don't want them flat and matronly which I'm afraid low profile will give me. Canceling surgery in the morning and just want to pay the money for a new surgeon. My body is extremely important! Advice please! :)

Doctor Answers 16

Breast Augmentation Revision

Thank you for the question and pictures.

It may behoove you to seek  consultation  with well experienced board-certified plastic surgeons. Communication will be the key to achieving the results you desire.

It will be very important to communicate your overall goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible .

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Natural appearing perky breasts that custom fit your body : cold-subfascial placement

I have an entirely different breast augmentation philosophy.  When I perform a breast augmentation I never use high profile implants and alweays get a perky tear drop shape.  This is because I do not believe the implant should dictate the shape of the breast.  In my hands the shape of the breast is dictated by my surgical dissection. This is because I use a unique technique called 'cold-subfascial augmentation.'  In this technique I leave the mucle alone (which only leads to strange movements in the implants and spreading between the breasts) and I elevate a strong layer called fascia to not only beautifully shape the breasts with upper pole fullness, but support them to protect the breast from the pressure and forces of gravity.  What results is a natural but full appearing breast that is better able to endure.  I highly recommend switching to subfascial for your body type.  I hope this helps!


All the best,


Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 73 reviews


You need to have a very open discussion with at least one more surgeon about what it is you are really looking for. This should include the pros and cons of an implant for additional volume or shape. Saline, gel, volume, profile, etc. You did not say if you are under the muscle or not. A 255 low profile saline implant can act like a high profile if you fill it enough, likely in the 300-350 range. This would not be that much smaller than you were. How much natural breast volume you have and what your skin envelope is will also influence the decision.

Robert H. Schnarrs, MD
Norfolk Plastic Surgeon
5.0 out of 5 stars 6 reviews

Downsizing implants

Time, weight and gravity are not on your side.  Going to a smaller implant may be just the answer for your problem. A gel implant will feel a bit more natural and will not be as round as an equivalent saline filled implant.    There are always consequences to the choices we make be sure to understand both sides of the story.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

I want perky small boobs that match my body size. I don't want them flat and matronly

Without an opportunity of examining you before surgery and now it is impossible to give you specific advice. It is however painfully obvious that you and your Plastic Surgeon did not communicate. How else can you explain how large 480cc breast implants ended up in your chest. Moreover, why would deflating the implants and replacing them with implants less than half their volume would give you the look you desire? Finally, what does your surgeon plan on doing with the large pocket created for the 480cc implants which would be too large for the much smaller new implants?

Before jumping into yet another procedure which would further complicate matters, I would consult SEVERAL Plastic surgeons who are members of The American Society of Plastic Surgery (ASPS  wwwPlasticSurgeryorg) to see what opinions you get from qualified surgeons who actually examined you. That would be money well spent.

You must understand that in a petite woman with not a large amount of breast tissue to cover the implant the choice of implants must be shifted to either moderate Profile or High Profile implants whose base matches your breast base (to cover the implant shell and its ripples) and I would suggest gel implants which ripple less and are lighter.

Take your time and educate yourself .

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Petite body: Consider silicone

My first impression from your photo was that your a poor candidate for saline which will most likely lead to rippling.  Silicone implants (subpectoral) would be more appropriate or you may want to find a surgeon using the Allergan 410 Cohesive gel (gummy bear) implant that are still awaiting FDA approval.  Silicone sizing isn't that difficult if you forget about volume or cc's. I now focus more on the implant diameter that accurately fits your breast/chest combined with implant projection.  That would give you basically three choices  moderate, mid range and high profile.  You should try these three options on (using the correct diameter) and one of them will look better that the other two.  After 20 years of using implant volume, I now use this method with high patient satisfaction and much less confusion and apprehension.

Lawrence W. Shaw, MD
Arizona Plastic Surgeon
4.9 out of 5 stars 73 reviews

Second Opinion Breast Revision

Communication is very important.  When seeing any plastic surgeon about breast implants you have to let them know what your goals and desired appearance is.  Bringing photos from magazines or the internet with you of what you consider to be a good breast for you can give the surgeon a good idea of what your thinking.  The surgeon has to communicate with you what is possible and safe for your body size and breast tissue parameters.  After examining and measuring you a recommended "range" of implant sized should be present to you customized for your body.  You should feel comfortable with your surgeon.   If not, get a second, third or fourth opinion.



Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 51 reviews

Breast implant choice

The best way for you to determine what is best for you is go for another opinion and find a surgeon that you feel comfortable with.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Downsizing, Not always as simple as a smaller implant

I agree, given your photo, a 480 cc implant is too large for your body unless you specifically stated you wanted to be big. Deflating your implants makes sense but you should give it more time to allow your skin to retract. A low profile implant may not be the best choice for your body/chest. Different profile types gets complicated with saline implants. Each manufacturer has multiple profiles in multiple volumes so picking that right implant for your body takes some time and thought. Given that you are thin you might also want to consider a Gel implant. Those with thin tissues benefit the most from Gels, and there are fewer profiles to consider. A high profile Gel could be a good choice for you. I don't think adjustable implants make sense. The adjustment range is modest and if they are underfilled you can get visible rippling, if they are ovefilled, they can be too firm.

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

Downsizing to adjustable saline implants will solve all your size worries

The best solution for you IMO is to go down to an ajustabble saline that can be modified to get exactly what you want.  All you do is sit in an exam chair and have saline injected in through a small valve under your skin until you get the result you think looks best.  Saline can also be removed if it ever gets too big.  Then after 4-6 months when there is no more swelling, the valves are removed under local anesthesia.  No more size worries.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.